Health Equity and Accountability Act of 2014

HR 45-To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010: entire bill HR 132: ObamaCare Repeal Act: entire bill Public Law No. 111-148- Patient Protection and Affordable Care Act: entire law Public Law No. 111-152- Health Care and Education Reconciliation Act of 2010: entire law HR 2457- Womens Preventive Health Awareness Campaign Act: entire bill HR 1975- Pregnant Workers Fairness Act: entire bill S. 942- Pregnant Workers Fairness Act: entire bill HR 2632- School-based Health Centers Program Reauthorization Act of 2013: entire bill HR 2676- Medicaid Information Technology to Enhance Community Health Act of 2013: entire bill S. 1286- Medicaid Information Technology to Enhance Community Health Act of 2013: entire bill HR 2810- To amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians' services, and for other purposes: amendments and provisions related to and affecting reproductive health and family planning S. 1871- SGR Repeal and Medicare Beneficiary Access Act of 2013: amendments and provisions related to and affecting reproductive health and family planning S. 1871- SGR Repeal and Medicare Beneficiary Access Act of 2013: amendments and provisions related to and affecting reproductive health and family planning S. 1009 - Chemical Safety Improvement Act: entire bill HR 4302- Protecting Access to Medicare Act: amendments and provisions related to and affecting reproductive health and family planning HR 3723 - Viral Hepatitis Testing Act of 2013: entire bill HR 5364/S 2461 - Amend title XXI of the Social Security Act to extend and improve the CHIP Program: entire bill HR 5353 - Amend title XIX of the Social Security Act to extend for 5 years payment parity with Medicare for primary care services: Entire bill HR 5380 - Medicare Parity Act: entire bill S 2662 - Telehealth Enhancement Act of 2014: entire bill HR 5481 - To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purpose (Flexibility in Health IT Reporting (Flex-IT) Act of 2014"): entire bill S 2629 - Preventive Care Coverage Notification Act: entire bill S 2694 - Ensuring Access to Primary Care for Women & Children Act: entire bill S 2908 - A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan, and for other purposes: entire bill S 2578/ HR 5150 - Protect Women's Health From Corporate Interference Act: entire bill HR 5294 - Health Equity and Accountability Act HR 5723 - Ensuring Access to Primary Care for Women & Children Act

Client expense: $73,680 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), Peace Corps, SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID)

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) H.R. 1717 - Discussed Medicare DMEPOS Market Pricing Program Act. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R.3830/S.1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) extension and CHIP Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice - Final 2014 CMS Guidance. H.R.5294, Health Equity & Accountability Act of 2014 - Addresses health care disparities; no endorsement due to budget impact. Medicare Advantage- Answered questions from some Hill offices. (no bill) Medicare Supplemental Insurance - Stated opposition to the elimination of first dollar coverage. (no bill) Discussed LTSS issues, including financing. (no bill)Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013. Discussed Medicaid expansion and estate recovery. (no bill) S. 2491, Discussed Medicare Protection Act. Discussed concern about CMS guidance on prescription drugs for medicare beneficiaries receiving hospice and coordination between hospice providers and medicare Part D sponsors. (no bill) Discussed long-term services and supports in Hill briefings. (no bill) H.R. 1173 - Discussed advance care planning, CMS payment for advance care planning, advanced illness, and Personalize Your Care Act.H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship and advancement of the bill. Discussed CMS information regarding healthcare marketplaces. H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) H.R. 83, Consolidated and Further Continuing Appropriations, 2015 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.(no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiares. (no bill) Discussed pending U.S. trade agreement negotiations, including trade promotional or 'fast track' authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) Discussed fraud, Medicare home healthcare, ways to find savings in Medicare without harming Medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). Discussed You've Earned A Say, ways to find savings in medicare without harming medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). PL.111-148 - Discussed implementation of provision to require reporting of nursing home staffing data based on payroll data and executive actions related to nursing homes, IMPACT Act, PL 113-185).. Discussed the draft legislation on Medicare fraud and abuse. Protecting the Integrity of Medicare Act. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740 - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 3830/S. 1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice-Final 2014 CMS Guidance. Discussed the Protecting Integrity of Medicare Act. (no bill) H.R.5435, Home Infusion Site of Care Act - Sent letter of endorsement H.R. 5958 - Discussed the ACO Improvement Act. H.J. Res. 124, Continuing Appropriations Resolution - Lobbied to protect funding levels for CMS program management under Continuing Resolution. H.R. 1179/S. 569 - Discussed observation impace on Medicare beneficiaries, counting time in observation toward Medicare's three-day inpatient hospital stay requirement for Medicare skilled nursing facility coverage, and the Improving Access to Medicare Coverage Act (CMS & MedPAC). PL. 113-295 - Responded to inquiry about Medicare offsets on Achieving a Better Life Expense Act.Discussed Medicare Advantage. (no bill) Discussed H.R. 3616, Protecting Seniors from Healthcare Fraud Act. Discussed observation care and "two-midnight rule". (no bill) H.R. 1070, the Removing Barriers to Colorectal Cancer Screening Act - Discussed and sent letter of endorsement to bill. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740, Medicaid Drug Savings Act - Discussed the requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed pending U.S. Trade agreement negotiations, including trade promotional or "fast track" authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S.1871/H.R. 4015/S.2110 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program. H.R. 4418, The Expanding Availability of Medicare Data Act - Sent letter of endorsement. Discussed Medicare data and billing transparency. (no bill) Discussed socio-economic risk adjustment. (no bill) S. 2240 - Discussed Medicare Choices Empowerment and Protection Act. H.R. 3024 - Discussed the Medicare Common Access Card Act. Discussed Medicare expansion. (no bill) Discussed Medicaid Labs Spousal Impoverishment provisions (PL. 111-198). Discussed transparency in healthcare. (no bill) Discussed Medicaid managed care regulations. (CMS, no bill) PL.111-148 - Discussed long-term services and supports broadly and Older Americans Act. Submitted comments on Medicare Physician fee schedule final rule and advance care planning (CMS - 1612-FC). Discussed Medicare enrollment and notification of eligibility. (no bill) Discussed Medicare in-office ancillary services exception. (no bill)

Client expense: $2,180,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Congressional Budget Office (CBO), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Labor, HHS Appropriations bill, 2015-Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm Bill. S. 562, Seniors Mental Health Access Improvement Act - Discussed the bill for eventual endorsement. Discussed need to suport family caregivers and long-term services and supports. (no bill) Discussed repeal of medical device tax. (no bill) Discussed proposed regulation relating to Medicaid expansion coverage and minimum essential coverage. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H.R.3850/S. 1562, Discussed Older Americans Act reauthorization legislation. H.R.3662, the Mental Health Access Improvement Act - Sent letter of endorsement. H.R.4879, the Research for All Act - Sent letter of endorsement. S.2348, the Removing Barriers to Colorectal Cancer Screening Act - Sent letter of endorsement. Discussed legislation to address health disparities. (no bill) H.R.5294 - Discussed Health Equity & Accountability Act of 2014; no endorsement due to budget implications. H.R. 83, Consolidated and Further Continuing Appropriations, 2015 - Lobbied to protect various healthcare programs serving seniors from disproportionate reduction.Discussed FTC participation in state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid, Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed perspectives on proposed ideas for legislation to address health disparities with HHS and CMS officials. Discussed H.R. 3717, the Helping Families in Mental Health Crisis Act. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed the Convention on the Rights of Persons with Disabilities. (no bill) H.R. 2835/S. 1647, Restoring Access to Medication Act of 2013 - Urged co-sponsorship of these bills. Discussed hospital readmissions. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H. R. 3850 - Discussed Older Americans Act reauthorization legislation. H.R. 5183, Better Care Act - Discussed legislation with staff regarding the bill. H.R. 5232, Notice of Observation Treatment & Implication for Care Eligibility (Notice Act) - Discussed legislation with staff. Discussed oral health and older adulsts. (no bill)

Client expense: $2,180,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Congressional Budget Office (CBO), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

H.R.5464 and draft Senate legislation, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division G, Title II Issues: Support funding for NIH, Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Children's Hospitals Graduate Medical Education program (CHGME), HRSA, biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Support emergency supplemental funding to prepare and respond to Ebola and to reimburse for Ebola Virus Disease treatment. H.R. 4486 and draft Senate legislation, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division I, Title II President's Budget, FY 2016 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Funding for Community Health Centers and the NHSC. Debt in Health Education Loan programs (DebtHELP) bill (draft) Issues: Expand National Health Service Corps State Loan Repayment program, align Department of Education and Health Resources and Services Administration student loan programs. S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction Act of 2013 Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. H.R. 487, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act, Sections 5503 and 5506 Issue: Redistribution of residency positions. Issue: Implementation of and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the Affordable Care Act. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform. Issue: Support the use of animals in medical research. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014 Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Implementation of Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose discretionary spending cuts through sequestration, including NIH, Titles VII and VIII health professions and nursing education programs, and other science programs. Issue: Support primary care workforce development S. 1759, Teaching Health Center Reauthorization Act Issue: Legislation to reauthorize the Teaching Health Center Program and payments. Issue: Draft legislation on pain education in undergraduate and graduate medical education. H.R.548/S. 1152, The Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 5294, Health Equity and Accountability Act of 2014 Issue: Support bill to improve health equity. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. H.R. 3698, Two Midnight Rule Delay Act of 2013 S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act. S. 2501, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. Issue: Educating health professionals regarding prescription drug abuse and appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Support use of holistic review in admissions. Issue: Support ACA consumer outreach and enrollment efforts. Issue: Implementation of the 340B drug discount program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Support preservation of funding for the Primary Care Residency Expansion program. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 5411, Trafficking Awareness Training for Health Care Act of 2014 Issue: Medical education curricula content pertaining to human trafficking. S. 2658/H.R.5580, Accelerating Biomedical Research Act Issue: To increase discretionary spending cap to increase funding for the National Institutes of Health (NIH). S. 2450, Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 4810, Veteran Access to Care Act Issue: Addressing VA backlogs by increasing care for veterans provided by non-VA facilities. S. 2115, American Cures Act H.R. 4384, America HEALS ACT Issue: Support establishment of a fund to provide an expanded and sustained investment in biomedical research. H.R. 4879, Research for All Act Issues: Support inclusion of male and female cells, tissues and animals in basic biomedical research. Support update of NIH guidelines to increase participation of women in clinical trials. Issue: FDA regulation of Laboratory Developed Tests (LDTs) S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 2645, The Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids S. 2942, The Infectious Disease Hospitals Hubs Act Issue: Support legislation to establish a network of hospitals in preparing for and responding to infectious diseases. Issue: Support nomination of Dr. Vivek Murthy as U.S. Surgeon General Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: U.S. Census Bureau on the American Community Survey CMS on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program CMS on final rule regarding definition of uninsured for purposes of Medicaid DSH limits HHS on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.) FDA on strategies for increasing patient involvement in regulatory processes. White House Ebola Response Coordinator offering to work with federal and state officials to prepare and respond to Ebola cases. NIH in response to an RFI related to the development of grant program to help facilitate the transition from training to independence. NIH on the consideration of sex as a biological variable in biomedical research The Patient-Centered Outcomes Research Institute (PCORI) on the proposed process for peer review and public release of its primary research finding. DEA on delaying the Disposal of Controlled Substances Final Rule.

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Support for distinguishable names for biosimilars Support for the Health Equity and Accountability Act (HR 5294)

Client expense: Not reported · Firm income: $10,000

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Oppose sequestration cuts which will disproportionately affect family planning services for low income women. Oppose budget cuts that threaten services to populations with unequal access to high quality health care. Support full implemantation of the 2010 Affordable Care Act; oppose efforts to repeal it. Oppose Cruz amendment to S Con Res 8 Support the inclusion of the Healthy Food Financing Initiative (HFFI) amendment in H. R. 1947 / S. 954Support $600 million from oil and gas revenues be invested in the Land and Water Conservation Fund and that the program be fully funded by 2015. Support continued funding for federal programs that are aimed at addressing racial and ethnic health disparities, including the Racial and Ethnic Approaches to Community Health (REACH) Program ($8.59 million increase of $63.49 million for the REACH program); the Office of Minority Health (OMH) at the U.S. Department of Health and Human Services ($55.8 million in FY 2014); the Area Health Education Centers (AHEC) program ($42.5 million in FY 2014); and the Health Careers Opportunity Program (HCOP). Also support $42.5 million for the HSS Office of Civil Rights in FY 2014; $283.3 million for the National Institute on Minority Health and Health Disparities in FY 2014; $520 million for Title VII and Title VIII of the Public Health Service Act n FY 2014; $327 million for Title X of the Public Health Service Act in FY 2014; $1.58 billion level discretionary funding in addition to maintaining all funds available through the mandatory Health Center Fund for Community Health Centers in FY 2014; $2.668 billion for the Ryan White Program in FY 2014; and a sufficient in amount to meet data collection objectives across HHS agencies, divisions, and programs in FY 2014. Support $7.9 billion in FY 2014 from the Department of Health and Human Services for Head Start activities. Oppose H.R. 2667. Oppose H.R. 2668. Support full implememntation of the 2010 Affordable Care Act. Oppose H.R. 45. Oppose Schweikert amendment to H.R. 1947 striking funds for the Healthy Food Financing Inititative. Ensure the full implememtation of the Affordable Care Act in Mississippi. Oppose H.R. 2775. Oppose H.R. 2009. Oppose H.R. 367. Stated that in response to questions regarding Section 1557 of the Afordable Care Act that the burdens of costly health care are not distributed evenly. Rather, they fall disproportionately on communities of color, which are more likely to experience higher rates of unemployment, to have jobs that do not have health insurance, and to have lower incomes that put higher insurance premiums out of their financial reach. Support Health Care Equity, especially as it applies to racial and ethnic minorities. Support the recommendation by the US Preventative Services Task Force on Lung Cancer Screening, giving such screening a favorable grade of B. Urged the Department of Health and Human Service's Office of Civil Rights (OCR) to administer section 1557 of the Affordable Care Act, through robust implementation and enforcement mechanisms, in the final regulations that OCR promulgates. Support data about how new drugs and devices work in women, minorities, and older Americans be publicly available to patients, clinicians, and researchers on a consistent and reliable basis.Support for including the following programs in any year-end health extenders package: the Qualified Individual (QI) program, the Transitional Medical Assistance (TMA) program, and Express Lane Eligibility (ELE) as well as the state incentive payment provisions and funding for quality improvement in the Childrens Health Insurance Reauthorization Act (CHIPRA). Support Protecting Seniors from Medication Labeling Mistakes. Oppose HR 4118. Support a release of the enrollment in the Affordable Care Act disaggregated by age, race, ethnicity, and primary language. Support improving the Tax Code to advance cost-effective policies that can bolster healthy lifestyles in key populations, and hold promise for halting or reversing the nations costly and unsustainable obesity epidemic. Support bringing the Affordable Care Act into compliance with the National Voter Registration Act of 1993 (NVRA). Support coverage of lung cancer screening as a Medicare benefit consistent with the final favorable recommendation of the US Preventive Services Task Force (USPSTF) issued December 31, 2013. Support lifting the ban on federal funding for syringe services programs (SSPs). Support President Obama's Boys and Young Men of Color Initiave, amd urge the initiative to focus on the following principals: Promoting Healthy Children, Families and Communities; Ensuring Educational Opportunity; Decriminalizing Young People of Color; Creating ; Economic Opportunity; and Promoting and Protecting Civic and Community Engagement. Support H.R. 4765. Support coverage of lung cancer screening as a Medicare benefit consistent with the final favorable recommendation of the US Preventive Services Task Force (USPSTF) , which gave the process a "B" grade. Support requested funding for the Ryan White HIV / AIDS Program, which offers health services for people living with HIV / AIDS, be set at $2.32 billion. Support HR 4810. Support the Nadler (NY) Housing for Persons with AIDS amendment to HR 4745. Oppose H. Res. 676. Support the Capps (CA) motion to recommit H.R. 935. Oppose H.R. 935. Oppose HR 3522. Support the request to the FDA to extend the comment period in Docket No.FDA-2013-N-0500, RIN 0910-AG94, in order to hear from healthcare and other stakeholders including providers and leaders who serve female, racial and ethnic minority populations, constituencies and consumers and who could offer expertise, experience, and perspective. Support H.R. 5294.Support full funding in FY15 for the Racial and Ethnic Approaches to Community Health (REACH) Program, the Office of Minority Health (OMH) at the U.S. Department of Health and Human Services, the Area Health Education Centers (AHEC) program, and the Health Careers Opportunity Program (HCOP). Support S. 2841 / H.R. 5507. Support a four-year extension of the Childrens Health Insurance Program (CHIP). Support HR 4765. Oppose funding cuts to programs which provide care and treatment, prevention, housing and support services for people with HIV/AIDS. Support nomination of Vivek Hallegere Murthy to be the next Surgeon General of the United States. Support a reallocation of the payroll tax to support the Social Security disability fund. Oppose HR 4118 Support HR 3474 Support HR 3979 Oppose HR 2575 Oppose HR 3522

Client expense: $68,750 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Credit Union Administration (NCUA), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Commission on Civil Rights, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 452/H.R. 962, the Medicare Diabetes Prevention Act. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. H.R. 2663/S. 1422, the Preventive Health Savings Act. H.R. 5294, the Health Equity and Accountability Act. S. 2210/H.R. 1783, the School Food Modernization Act.S. 452/H.R. 962, the Medicare Diabetes Prevention Act. Support entire bill; provides for Medicare coverage of National Diabetes Prevention Program. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. Support entire bill; provides funding for the establishment of a tracking and surveillance system at the CDC and provides grant funding for public health research on gestational diabetes. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. Support entire bill; requires states to report on and reach physical education benchmarks; and requires training of physical education teachers and school administrators; physical education curriculum; and dedicated school space for physical education and physical activity. H.R. 2663/S. 1422, the Preventive Health Savings Act. Support entire bill; requires the Director of the Congressional Budget Office, upon a request by the chairman or ranking minority member of certain congressional committees, to determine if proposed legislation would result in reductions in budget outlays in budgetary outyears through the use of preventive health and preventive health services. H.R. 5294, the Health Equity and Accountability Act. Support provisions addressing diabetes, including the Eliminating Disparities in Diabetes Prevention, Access and Care Act (sections 771-775) and the Gestational Diabetes Act (section 509). S. 2210/H.R. 1783, the School Food Modernization Act. Support entire bill; provides loans to schools to update kitchen equipment in order to prepare healthy foods for students. Issues worked on not yet reflected in legislation: The Physician Payments Sunshine Act (also called the Open Payments Program) of the Affordable Care Act. Requires manufacturers of drugs, medical devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. The Association would like to see the Centers for Medicare and Medicaid Services make an Open Payments Program reporting exemption for indirect payments made to voluntary health agencies (VHAs) in cases when an applicable manufacturer grants full and independent discretion to VHAs in selecting recipients for funding. 21st Century Cures Initiative. The initiative was convened by the House Energy and Commerce Committee to address ways to improve medical research and development and delivery of innovative new treatments and cures. The Committee is developing legislation and the Association is particularly interested in any provisions that may relate to medical research. Surgeon General of the United States: Support the confirmation of Dr. Vivek Murthy for the post of Surgeon General of the United States. Support Draft Recommendation for Screening for Type 2 diabetes released by the United States Preventive Services Task Force. The draft recommendation suggests screening for type 2 diabetes in adults with multiple risk factors.

Client expense: $128,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Mental Health in Schools Act (S. 195/H.R. 628) Excellence in Mental Health Act (S. 264/ H.R. 1263) Mental Health First Aid Act (S. 153/H.R. 274) Pediatric Subspecialty and Mental Health Workforce Reauthorization Act (H.R. 1827) Student Support Act (H.R. 320) Childrens Trauma Recovery Act (S. 380) Mental Health on Campus Act (H.R. 1100) Behavioral Health IT Act (S.1685/H.R. 2957) and Behavioral Health IT Coordination Act (S.1517) Fiscal Year 2015 Omnibus Appropriations Bill (HR 83) Achieving a Better Life Experience Act of 2014 or the ABLE Act of 2014 - (H.R.647) Health Equity and Accountability Act of 2014 (H.R. 5294)

Client expense: $5,347 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Mental Health in Schools Act (S. 195/H.R. 628) Excellence in Mental Health Act (S. 264/ H.R. 1263) Mental Health First Aid Act (S. 153/H.R. 274) Garrett Lee Smith Memorial Act Reauthorization of 2013 (S.116/H.R. 2734) Pediatric Subspecialty and Mental Health Workforce Reauthorization Act (H.R. 1827) Student Support Act (H.R. 320) Childrens Trauma Recovery Act (S. 380) Mental Health on Campus Act (H.R. 1100) Behavioral Health IT Act (S.1685/H.R. 2957) and Behavioral Health IT Coordination Act (S.1517) Fiscal Year 2015 Omnibus Appropriations Bill (HR 83) Justice and Mental Health Collaboration Act of 2013 (MIOTCRA; S. 162/H.R. 401) Helping Families in Mental Health Crisis Act (H.R. 3717) Strengthening Mental Health in our Communities Act (H.R 4574) Medical Evaluation Parity for Servicemembers (MEP) Act (H.R 4305) Promoting Health Minds for Safer Communities Act of 2014 (H.R 4783) Keeping All Students Safe Act (H.R. 1893, S. 2036) Caring for Americas Heros Act (H.R. 4656/S. 2276 ) The Second Chance Reauthorization Act of 2013 (S. 1690/H.R. 346) Achieving a Better Life Experience Act of 2014 or the ABLE Act of 2014 - (H.R.647) Health Equity and Accountability Act of 2014 (H.R. 5294) The Social Impact Bond Act (HR 4885) Caring for Americas Heroes Act (HR 4656)

Client expense: $5,347 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

HEALTH CARE Mental Health First Aid Act of 2013 (S. 153/H.R. 274), all provisions related to authorizing a demonstration program to train college faculty and staff in Mental Health First Aid, a community education program that helps people identify, understand, and respond to signs of mental illnesses and addictions and deal with psychiatric crises Behavioral Health Information Technology Act (S. 1517/S. 1685/H.R. 2957), all provisions related to expanding federal incentive payments for the adoption and meaningful use of electronic health records to behavioral health providers and facilities Helping Families in Mental Health Crisis Act of 2013 (H.R. 3717), all provisions related to authorizing healthcare providers to bill Medicaid for mental health and primary care services provided to the same patient on the same day, the reauthorization of the Garrett Lee Smith Memorial Act, the reauthorization of MIOTCRA, enactment of a demonstration program based on the Excellence in Mental Health Act, and strengthening the six protected classes language in Medicare Part D. Strengthening Mental Health in Our Communities Act of 2014 (H.R. 4574), all provisions related to the inclusion of the Mental Health First Aid Act, the reauthorization of important Justice Department initiatives as well as critical SAMHSA programs including the National Suicide Prevention Hotline [1-800-273-TALK], the Garrett Lee Smith Memorial Act suicide prevention programs and the Primary Care Behavioral Health Integration Grants. Caring for Americas Heroes Act (S.2276/H.R. 4656), all provisions related to eliminating the limit on the number of days each year impatient mental health services may be provided to military dependents under the Department of Defense TRICARE program. Caring for Military Children with Developmental Disabilities Act of 2014 (H.R. 4630/S. 2333), all provisions related to including in the treatment of military dependents' developmental disabilities under the Department of Defense TRICARE program behavioral health treatment, including applied behavior analysis, that is prescribed by a physician or psychologist. Craig Thomas Rural Hospital and Provider Equity Act of 2014 (S. 2359), all provisions related to ensuring that residents of rural and frontier communities should have access to affordable, quality health care. Restoring Veterans Trust Act of 2014 (S. 2413), all provisions related to including a new project, the Community Mental Health Partnership Pilot Program, which would connect medical centers of the Department of Veterans Affairs with surrounding community mental health and substance use treatment providers to increase access to services, improve health outcomes, and ensure veterans receive behavioral healthcare that meets the minimum clinical mental health guidelines endorsed by the Veterans Health Administration. H. Res. 572, all provisions related to expressing support for designation of the first full week of May as "National Mental Health No Stigma Week". Opioid Overdose Reduction Act of 2014 (S. 2092/H.R. 4288), all provisions related to exempting from liability for harm caused by the emergency administration of an opioid overdose drug. Opioid Abuse Prevention and Treatment Act (H.R.5587) all provisions related to new grants deterring prescription drug abuse and assisting individuals who are receiving addiction treatment. Overdose Prevention Act (S. 2755) all provisions related to the funding of overdose prevention programming and research efforts to reduce opioid overdose deaths, creation of a task force to recommend a national public health campaign and funding of research and testing of new treatment and prevention methods. Breaking Addictions Act (H.R. 5136), all provisions related to establishing a five-year demonstration project for 8-10 states in which federal reimbursement would be permitted for Medicaid services provided in certain residential settings known as Institutes for Mental Disease. Health Equity and Accountability Act (H.R. 5294) all provisions related to the addition of mental and behavioral health social workers to existing loan repayment programs to bolster the behavioral health workforce. Comprehensive Addiction and Recovery Act (S. 2839/H.R. 5845) all provisions related to a series of resources and incentives to help states and local governments expand drug treatment, prevention and recovery efforts. ABLE Act (H.R. 647) all provisions related to allowing families to establish savings accounts for the qualified expenses of people with blindness or physical or mental disabilities who incurred the disabilities before the age of 26.

Client expense: $71,600 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5294 - Health Equity and Accountability Act of 2014

Client expense: $490,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, U.S. Trade Representative (USTR), White House Office

HR 5294 - Health Equity and Accountability Act of 2014 HR 83 - Improving access to home care services Sale of hospitals in California HR 4414 - Expatriate Health Coverage Clarification Act Federal income tax exclusion for employer sponsored health care Federal excise tax on high-cost employer sponsored health care

Client expense: $490,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, U.S. Trade Representative (USTR), White House Office

HR 5294 - Health Equity and Accountability Act of 2014 HR 83 - Protecting the public and workers at risk of Ebola exposure Medicaid funding/benefits Medicare funding/benefits/policy/eligibility age/means test

Client expense: $490,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, U.S. Trade Representative (USTR), White House Office

S. 116/H.R. 2734 Garrett Lee Smith Memorial Act Reauthorization of 2013 S. 2373 Funding for Research by CDC on Firearms Safety or Gun Violence Prevention H.R. 5294 Health Equity and Accountability Act of 2014 (HIV/AIDS & Mental Health Provisions) Health Disparities Mental and Behavioral Health of Military Personnel, Veterans, and Families H.R. 3717 Helping Families in Mental Health Crisis Act of 2013 H.R. 4574 Strengthening Mental Health in Our Communities Act of 2014 H.R. 4783/S. 2872 Promoting Health Minds for Safer Communities Act of 2014 H.R. 4784 End of Purchase of Firearms by Dangerous Individuals Act of 2014

Client expense: $140,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

FY 15 DOD Appropriations bill. HR 5294

Client expense: Not reported · Firm income: $22,500

Government targets: Defense, Dept of (DOD)

Americans Giving Care to Elders Act (S.1485) Authority for Mandate Delay Act (H.R.2667) Comments/Testimony to FDA-Sec.907 of FDASIA Comments to CMS-Exchanges & Health Plans Qulaity Rating SystemCommunity Parks Revitalization Act (H.R.2424) Community Prevention Grants Continuous Coverage Act (S.1699) Draft Research Priorities (PCORI) EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2011 (H.R.3144) Fairness for American Families Act (H.R.2668) Food and Drug Administration Strategic Priorities 2014-2018 (FDA-2014-N-0833) Health Care Waiver Fairness Act (H.R. 2700) Health Equity and Accountability Act (H.R.5294) Healthy Kids Outdoors Act (H.R.4706) HHS- Clinical Trials Insurance Coverage (ACA Sec. 2709) If You Like Your Health Care, You Can Keep It Act (S.1617) Josh Miller Helping Everyone Access Responsive Treatment in Schools (HEARTS) Act (H.R.1377) Keeping the Affordable Care Act Promise Act (S.1642) Keep Your Health Plan Act (H.R.3350) Menu Labeling (ACA Section 4205) Newborn Screening Saves Lives Reauthorization Act of 2013 (H.R. 1281/ S.1471) No Child Left Inside Act of 2013 (H.R.2702) Next Generation Research Act (S.1552) Palliative Care and Hospice Education Training Act (H.R.1339 & S.641) Patient Centered Quality Care for Life Act (H.R.1666) Patient Protection and Affordable Care Act (P.L. 111-148; P.L. 111-152) - Implementation Physical Activity Guidelines for Americans Act (S.531 & H.R.2179) 2015 Physician Fee Schedule (CMS-1612-P) Prevention and Public Health Fund (ACA Section 4002) Proposed Rule on 90-Day Waiting Period (DOL/CMS/IRS) Proposed Rule on Exchange & Market Standards (CMS) Providing Accountability and Transperency to Incentivize Economically Necessary Transition in Health Care Act (H.R. 2688) Quality Rating System Scoring Specifications Comments (CMS) Research for All Act (H.R. 4879) Return to Work Act (S.1026 & H.R.3351) Revised Medical Criteria for Evaluating Neurological Disorders (SSA-2006-0140) The HELP America Act (S.39) To Improve, Coordinate & Enhance Rehabilitation Research at NIH (S.1027) The Helping Sick Americans Now Act (H.R.1549) The Personal Health Investment Today Act (H.R. 956) Veterans Emergency Medical Technician Act of 2013 (H.R. 1281/ S. 1471) Wireless E911 Location Accuracy Requirements (07-114; FCC 14-13) Women's Preventive Health Awareness Campaign Act (H.R. 2457)

Client expense: $19,160 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 5294, the Health Equity and Accountability Act Medicare physician fee schedule Biosimilars naming

Client expense: Not reported · Firm income: $10,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES

HR 45-To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010: entire bill HR 132: ObamaCare Repeal Act: entire bill Public Law No. 111-148- Patient Protection and Affordable Care Act: entire law Public Law No. 111-152- Health Care and Education Reconciliation Act of 2010: entire law HR 2457- Womens Preventive Health Awareness Campaign Act: entire bill HR 1975- Pregnant Workers Fairness Act: entire bill S. 942- Pregnant Workers Fairness Act: entire bill HR 2632- School-based Health Centers Program Reauthorization Act of 2013: entire bill HR 2676- Medicaid Information Technology to Enhance Community Health Act of 2013: entire bill S. 1286- Medicaid Information Technology to Enhance Community Health Act of 2013: entire bill HR 2810- To amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians' services, and for other purposes: amendments and provisions related to and affecting reproductive health and family planning S. 1871- SGR Repeal and Medicare Beneficiary Access Act of 2013: amendments and provisions related to and affecting reproductive health and family planning S. 1871- SGR Repeal and Medicare Beneficiary Access Act of 2013: amendments and provisions related to and affecting reproductive health and family planning S. 1009 - Chemical Safety Improvement Act: entire bill HR 4302- Protecting Access to Medicare Act: amendments and provisions related to and affecting reproductive health and family planning HR 3723 - Viral Hepatitis Testing Act of 2013: entire bill HR 5364/S 2461 - Amend title XXI of the Social Security Act to extend and improve the CHIP Program: entire bill HR 5353 - Amend title XIX of the Social Security Act to extend for 5 years payment parity with Medicare for primary care services: Entire bill HR 5380 - Medicare Parity Act: entire bill S 2662 - Telehealth Enhancement Act of 2014: entire bill HR 5481 - To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purpose (Flexibility in Health IT Reporting (Flex-IT) Act of 2014"): entire bill S 2629 - Preventive Care Coverage Notification Act: entire bill S 2694 - Ensuring Access to Primary Care for Women & Children Act: entire bill S 2908 - A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan, and for other purposes: entire bill S 2578/ HR 5150 - Protect Women's Health From Corporate Interference Act: entire bill HR 5294 - Health Equity and Accountability Act

Client expense: $484,122 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), Peace Corps, SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID)

Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions and prescription drug abuse. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act (Public Law 113-5) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 7.Animal Drug and Animal Generic Drug User Fee Act (Public Law 113-14) 8.Healthier Lifestyles and Prevention America Act (S. 39) 9.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392/H.R. 2160) 10.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 11.Personal Health Investment Today Act (H.R. 956) 12.A bill to provide for a sequester replacement (S. 16/S. 799) 13.American Family Economic Protection Act of 2013 (S. 388) 14.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933/Public Law 113-6) 15.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 16.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 17.Physical Activity Guidelines for Americans Act (S. 531/H.R. 2179) 18.Firearm Safety and Public Health Research Act (H.R. 321) 19.Energy Consumers Relief Act (S. 1363/H.R. 1582) 20.Common Sense Nutrition Disclosure Act (H.R. 1249/S. 1756) 21.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 22.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 23.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 24.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 25.FIT Kids Act (S. 1033/H.R. 2178) 26.Strengthening Americas Schools Act (S. 1094) 27.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 28.Fit to Serve Act (S. 976) 29.Climate Change Health Protection and Promotion Act (H.R. 2023/S. 2864) 30.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 31.Student Success Act (H.R. 5) 32.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 33.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 34.Senate FY14 Labor, Health and Human Services, and Education Bill (S. 1284) 35.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 36.Pharmacy Compounding Quality and Accountability Act (S. 959) 37.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 38.Implementation of Drug Supply Chain Security Act (P.L. 113-54) 39.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 40.Healthy Families Act (H.R. 1286/S. 631) 41.FY2014 Continuing Resolution (H.J. Res. 59) 42.Pharmaceutical Quality, Security and Accountability Act (S. 959) 43.Energy Consumers Relief Act (S. 1363/H.R. 1582) 44.Increasing the Safety of Prescription Drug Use Act (S. 1657) 45.National Energy Tax Repeal Act (S. 1324) 46.Saving Coal Jobs Act of 2013 (S. 1514/H.R. 5077) 47.Community Parks Revitalization Act (H.R. 2424) 48.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 49.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 50.Nutrition Reform and Work Opportunity Act (H.R. 3102) 51.Health Equity and Accountability Act (H.R. 5294) 52.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 53.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 54.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 55.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 56.The Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102, Public Law 113-79) 57.Better Care, Lower Cost Act (S. 1932/H.R. 3890) 58.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 59.The Consolidated Appropriations Act of 2014 (H.R. 3547/Public Law 113-76 60.Strategies to Address Antimicrobial Resistance (STAAR) Act (S. 2236/H.R. 2285) 61.New Opportunities for Bicycling and Pedestrian Infrastructure Financing Act of 2014 (H.R. 3978) 62.Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 3322) 63.Electricity Security and Affordability Act (S. 1905/H.R. 3826) 64.Stop Overdose Stat Act (HR 4169) 65.Overdose Prevention Act (S 2755) 66.Opioid Overdose Reduction Act (S. 2092/H.R. 4288) 67.Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act of 2014 (DISARM Act) (H.R. 4187) 68.Child Care and Development Block Grant Act of 2014 (S. 1086) 69.Departments of Labor, Health and Human Services and Education And Related Agencies Fiscal Year 2015 Appropriations Bill (including H.R. 5464) 70.Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2015 (S. 2389 / H.R. 4800) 71.Department of the Interior, Environment, and Related Agencies appropriations legislation, 2015 (including H.R. 5171) 72.MAP-21 Reauthorization Act (S. 2322) 73.Stop Subsidizing Childhood Obesity Act (S. 2342/H.R. 2831) 74.ENRICH Act (H.R. 4427) 75.Healthy Kids Outdoors Act of 2014 (S. 2367/H.R. 4706) 76.Summer Meals Act of 2014 (S. 2527/HR. 5012) 77.Long-Term SCORE Act (H.R. 4444) 78.American Cures Act (S. 2115/H.R. 4384) 79.A joint resolution to disapprove a rule of the Environmental Protection Agency relating to greenhouse gas emissions from electric utility generating units. (S.J. Res 30) 80.Fit for Life Act of 2014 (H.R.4765) 81.School Food Modernization Act (S. 2210/H.R. 1783) 82.Protecting Children from Electronic Cigarette Advertising Act of 2014 (S. 2014/H.R. 4325) 83.Pedestrian Safety Act of 2014 (S. 2284) 84.Safe Streets Act of 2014 (S. 2004/H.R. 2468) 85.The Recovery Enhancement for Addiction Treatment Act (S. 2645) 86.FY 2015 Financial Services and General Government Appropriations bill, in support of an appropriation for the National Alliance for Model State Drug Laws (including H.R. 5016) 87.Vector-Borne Disease Research Accountability and Transparency Act (H.R. 4701) 88.Highway and Transportation Funding Act of 2014 (H.R. 5021/Public Law 113-520) 89.Full-Service Community Schools Act of 2014 (H.R. 5168) 90.PREPARE Act of 2014 (H.R. 5314) 91.Waters of the United States Regulatory Overreach Protection Act of 2014 (S. 2496/H.R. 5078) 92.American Energy Solutions for Lower Costs and More American Jobs Act (H.R.

Client expense: $38,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

H.R. 1466, S. 997, Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act, All provisions. H.R. 3717, Helping Families in Mental Health Crisis Act of 2013, Issues pertaining to social determinants, workforce issues, and other provisions relating to social work.. H.R. 5294, Health Equity and Accountability Act of 2014Issues pertaining to the role of social work education and training at the VA. Issues pertaining to the Minority Fellowship Program. Issues pertaining to the role of social work and the changing healthcare environment, including integrated team-based care, social determinance of health and integrating behavorial health.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 452/H.R. 962, the Medicare Diabetes Prevention Act. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. H.R. 2663/S. 1422, the Preventive Health Savings Act. H.R. 3322, the Eliminating Disparities in Diabetes Prevention, Access and Care Act. S. 1932, the Better Care, Lower Cost Act. H.R. 5294, the Health Equity and Accountability Act. S. 2210/H.R. 1783, the School Food Modernization Act.S. 452/H.R. 962, the Medicare Diabetes Prevention Act. Support entire bill; provides for Medicare coverage of National Diabetes Prevention Program. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. Support entire bill; provides funding for the establishment of a tracking and surveillance system at the CDC and provides grant funding for public health research on gestational diabetes. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. Support entire bill; requires states to report on and reach physical education benchmarks; and requires training of physical education teachers and school administrators; physical education curriculum; and dedicated school space for physical education and physical activity. H.R. 2663/S. 1422, the Preventive Health Savings Act. Support entire bill; requires the Director of the Congressional Budget Office, upon a request by the chairman or ranking minority member of certain congressional committees, to determine if proposed legislation would result in reductions in budget outlays in budgetary outyears through the use of preventive health and preventive health services. H.R. 3322, the Eliminating Disparities in Diabetes Prevention, Access and Care Act. Support entire bill; expands resources at NIH, CDC, the Health Resources and Services Administration, and the Indian Health Service to promote research, treatment and education regarding diabetes in minority populations. S. 1932, the Better Care, Lower Cost Act. Support part of bill; establishes a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions, and for other purposes. H.R. 5294, the Health Equity and Accountability Act. Support provisions addressing diabetes, including the Eliminating Disparities in Diabetes Prevention, Access and Care Act (sections 771-775) and the Gestational Diabetes Act (section 509). S. 2210/H.R. 1783, the School Food Modernization Act. Support entire bill; provides loans to schools to update kitchen equipment in order to prepare healthy foods for students. Issues worked on the Hill not yet reflected in legislation: Special Diabetes Program. The Special Diabetes Program consists of two mandatory funding streams Special Diabetes Program for type 1 and Special Diabetes Program for Indians. The funding is set to expire September 30, 2015 unless Congress acts to reauthorize the program. United States Preventive Services Task Force (USPSTF). Support any efforts to require the USPSTF to update its recommendation for diabetes screening, including gestational diabetes screening, based on new evidence. The Physician Payments Sunshine Act (also called the Open Payments Program) of the Affordable Care Act. Requires manufacturers of drugs, medical devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. The Association would like to see the Centers for Medicare and Medicaid Services make an Open Payments Program reporting exemption for indirect payments made to voluntary health agencies (VHAs) in cases when an applicable manufacturer grants full and independent discretion to VHAs in selecting recipients for funding.

Client expense: $123,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Labor, HHS Appropriations bill, 2015-Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm Bill. S. 562, Seniors Mental Health Access Improvement Act - Discussed the bill for eventual endorsement. Discussed need to suport family caregivers and long-term services and supports. (no bill) Discussed repeal of medical device tax. (no bill) Discussed proposed regulation relating to Medicaid expansion coverage and minimum essential coverage. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H.R.3850/S. 1562, Discussed Older Americans Act reauthorization legislation. H.R.3662, the Mental Health Access Improvement Act - Sent letter of endorsement. H.R.4879, the Research for All Act - Sent letter of endorsement. S.2348, the Removing Barriers to Colorectal Cancer Screening Act - Sent letter of endorsement. Discussed legislation to address health disparities. (no bill) H.R.5294 - Discussed Health Equity & Accountability Act of 2014; no endorsement due to budget implications. H.J. Res. 124, Continuing Appropriations Resolution, 2015 - Lobbied to protect various healthcare programs serving seniors from disproportionate reduction under Continuing Resolution.Discussed FTC participation in state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid, Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed perspectives on proposed ideas for legislation to address health disparities with HHS and CMS officials. Discussed H.R. 3717, the Helping Families in Mental Health Crisis Act. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed the Convention on the Rights of Persons with Disabilities. (no bill) H.R. 2835/S. 1647, Restoring Access to Medication Act of 2013 - Urged co-sponsorship of these bills. Discussed hospital readmissions. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H. R. 3850 - Discussed Older Americans Act reauthorization legislation. H.R. 5183, Better Care Act - Discussed legislation with staff regarding the bill. H.R. 5232, Notice of Observation Treatment & Implication for Care Eligibility (Notice Act) - Discussed legislation with staff.

Client expense: $2,380,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Congressional Budget Office (CBO), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) H.R. 1717 - Discussed Medicare DMEPOS Market Pricing Program Act. Discussed implementation of regulations regarding minimum wage and overtime for home care workers and consumer-directed care. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H. R. 1588/S.740 - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R.3830/S.1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) extension and CHIP Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice - Final 2014 CMS Guidance. H.R.5294, Health Equity & Accountability Act of 2014 - Addresses health care disparities; no endorsement due to budget impact. Medicare Advantage- Answered questions from some Hill offices. (no bill) Medicare Supplemental Insurance - Stated opposition to the elimination of first dollar coverage. (no bill)Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013. Discussed Medicaid expansion and estate recovery. (no bill) Discussed Medicaid and asset transfers. (no bill) H.R.4994/S. 2553, Improving Medicare Post-Acute Care Transformation Act of 2014 - Discussed the bill and AARP support for the bill. Shared our letter of support. S. 2491, Discussed Medicare Protection Act. Discussed concern about CMS guidance on prescription drugs for medicare beneficiaries receiving hospice and coordination between hospice providers and medicare Part D sponsors. (no bill) H.R. 1179/S.569 - Submitted statement for the record for Senate Aging Committee hearing on Observation Improving Access to Medicare Coverage Act and Notice of Observation Treatment and Implication for Care Eligibility Act (H.R. 5232). Discussed aging in place, HCBS, family caregiving. (no bill)H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship and advancement of the bill. Discussed CMS information regarding healthcare marketplaces. H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill) Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.(no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiares. (no bill) Discussed pending U.S. trade agreement negotiations, including trade promotional or 'fast track' authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) Discussed fraud, Medicare home healthcare, ways to find savings in Medicare without harming Medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). Discussed You've Earned A Say, ways to find savings in medicare without harming medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). PL.111-148 - Discussed implementation of provision to require reporting of nursing home staffing data based on payroll data. Discussed the draft legislation on Medicare fraud and abuse. Protecting the Integrity of Medicare Act. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740 - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 3830/S. 1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice-Final 2014 CMS Guidance. Discussed the Protecting Integrity of Medicare Act. (no bill) H.R.5435, Home Infusion Site of Care Act - Sent letter of endorsement H.R. 5958 - Discussed the ACO Improvement Act. H.R. 5232 - Discussed and sent letter on the Notice of Observation Treatment and Implication for Care Eligibility Act. Met with Centers for Medicare and medicaid services to discuss three-day stay requirement for medicare skilled nursing coverage. H.J. Res. 124, Continuing Appropriations Resolution - Lobbied to protect funding levels for CMS program management under Continuing Resolution. Discussed coordination with hospice providers and Medicare Part D plans guidance for Medicare beneficiaries receiving hospice. (no bill) H.R. 1179/S. 569 - Discussed observation impace on Medicare beneficiaries, counting time in observation toward Medicare's three-day inpatient hospital stay requirement for Medicare skilled nursing facility coverage, and the Improving Access to Medicare Coverage Act (CMS & MedPAC). Discussed caucus for military/veteran family caregivers and support for family caregivers. (no bill) Discussed draft working paper on impact of observation on Medicare beneficiary out of pocket. (no bill)Discussed District of Columbia EPD Medicaid HCBS waiver. (no bill) H.R. 5232 - Discussed legislation and shared letter of support for the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act of 2014. Discussed Medicare Advantage. (no bill) Discussed H.R. 3616, Protecting Seniors from Healthcare Fraud Act. Discussed observation care and "two-midnight rule". (no bill) H.R. 1070, the Removing Barriers to Colorectal Cancer Screening Act - Discussed and sent letter of endorsement to bill. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740, Medicaid Drug Savings Act - Discussed the requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed pending U.S. Trade agreement negotiations, including trade promotional or "fast track" authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S.1871/H.R. 4015/S.2110 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program. H.R. 4418, The Expanding Availability of Medicare Data Act - Sent letter of endorsement. Discussed Medicare data and billing transparency. (no bill) Discussed socio-economic risk adjustment. (no bill) S. 2240 - Discussed Medicare Choices Empowerment and Protection Act. H.R. 3024 - Discussed the Medicare Common Access Card Act. H.R. 4673-Discussed the Bundling and Coordinating Post Acute Care (BACPAC) Act and shared views on post-acute care return. Discussed Medicare expansion. (no bill) Discussed Medicaid Labs Spousal Impoverishment provisions (PL. 111-198). S. 2361, Discussed Stop Schemes and cons against Medicare and seniors. Discussed transparency in healthcare. (no bill) Discussed LTSS Hill briefing series. (no bill) Met with CMS on observation status. (no bill) Submitted comment letter to CMS on the FY2015 Medicare Hospice proposed regulation. Shared comment letter with some Hill staff. H.R. 4994/S.2553 - Shared letter of support for Improving Medicare Post-Acute Care Transformation Act and discussed the status of the bill. Discussed long-term survey and supports Hill briefings. (no bill) Submitted comment letter to CMS on the FY 2015 Medicare Home Health proposed regulation. Shared draft working paper on impact of observation on Medicare beneficiary out of pocket cost. (no bill) Responded to inquiry on observation. (no bill)

Client expense: $2,380,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Congressional Budget Office (CBO), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Implementation of the Affordable Care Act and Medicare Improving access to home care services HR 5364, S 2461 - Children's Health Insurance Program (CHIP) Extension HR 5294 - Health Equity and Accountability Act of 2014 Increasing access to medical language interpreters HR 3522 - Employee Health Care Protection Act (part of HR 4) HR 4414 - Expatriate Health Coverage Clarification Act Repeal of Affordable Care Act's excise tax on high cost plans HR 4 - Jobs for America Act HR 2575 - Save American Workers Act (part of HR 4) S 2253 - Health Care Fairness and Stability Act Protecting the ACA in general S 2578 - Protect Women's Health from Corporate Interference Act H Res 676 - Authorizing civil action against President with respect to the implementation of the Affordable Care Act Federal income tax exclusion for employer-sponsored health care Federal excise tax on high-cost employer-sponsored health care

Client expense: $550,000 · Firm income: Not reported

Government targets: Council of Economic Advisers (CEA), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office

S 2087, S 2491 - Medicare Protection Act, reconciliation budget rules Implementation of the Affordable Care Act and Medicare Improving access to home care services HR 5364, S 2461 - Children's Health Insurance Program (CHIP) Extension HR 4998, S 2552 - Medicare Advantage Participant Bill of Rights Act Reduce prescription drug costs in Medicare/Medicaid HR 5294 - Health Equity and Accountability Act of 2014 Increasing access to medical language interpreters Conflict of interest section of Home and Community Based Regulations issued by CMS. Asked Senate help to obtain CMS intent of regulation Medicaid funding/benefits Medicare funding/benefits/policy/eligibility age/mean test

Client expense: $550,000 · Firm income: Not reported

Government targets: Council of Economic Advisers (CEA), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office

HR 5294 - Health Equity and Accountability Act of 2014 Increasing access to medical language interpreters HR 3899, S 1945 - Voting Rights Amendment Act of 2014

Client expense: $550,000 · Firm income: Not reported

Government targets: Council of Economic Advisers (CEA), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office

Draft House and Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015, Title II H.R.5464, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015, Title IIIssues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Children's Hospitals Graduate Medical Education program (CHGME), Health Resources and Services Administration (HRSA), biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. H.R. 4486 and draft Senate, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015, Title II President's Budget, FY 2016 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Funding for Community Health Centers and the National Health Service Corps. Debt in Health Education Loan programs (Debt HELP) bill (draft) Issues: Expand National Health Service Corps State Loan Repayment program, align Department of Education and Health Resources and Services Administration student loan programs. S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction Act of 2013 Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. P.L. 111-148, Patient Protection and Affordable Care Act, Title V Issue: Reauthorizing National Health Service Corps Fund. H.R. 487, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act, Sections 5503 and 5506 Issue: Redistribution of residency positions. Issue: Implementation of and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the Affordable Care Act. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform. Issue: Support the use of animals in medical research. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014 Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission.Issue: Implementation of Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose discretionary spending cuts through sequestration, including NIH, Titles VII and VIII health professions and nursing education programs, and other science programs. Issue: Support primary care workforce development S. 1759, Teaching Health Center Reauthorization Act Issue: Legislation to reauthorize the Teaching Health Center Program and payments. Issue: Draft legislation on pain education in undergraduate and graduate medical education. H.R.548/S. 1152, The Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 5294, Health Equity and Accountability Act of 2014 Issue: Support bill to improve health equity. Issue: Oppose implementation of Hospital-Acquired Condition (HAC) program and inclusion of Medicare add-on payments in HAC reduction program and penalties. H.R. 3698, Two Midnight Rule Delay Act of 2013 S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 Issue: Support delay of enforcement of new Centers for Medicare and Medicaid Services (CMS) inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare Graduate Medical Education (GME) per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act. S. 2501, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2015 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; Oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics. H.R. 4427, Enrich Act Draft Senate legislation Issue: Educating health professionals on nutrition.Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Support use of holistic review in admissions. Issue: Support ACA consumer outreach and enrollment efforts. Issue: Implementation of the 340B drug discount program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Support preservation of funding for the Primary Care Residency Expansion program. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 5411, Trafficking Awareness Training for Health Care Act of 2014 Issue: Medical education curricula content pertaining to human trafficking. S. 2658/H.R.5580, Accelerating Biomedical Research Act Issue: To increase discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 4942, Underserved Veterans Access to Health Care Act Issue: Support increasing funding for VA GME and Medicare GME. S. 2450, Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 4810, Veteran Access to Care Act Issue: Addressing VA backlogs by increasing care for veterans provided by non-VA facilities. S. 2115, American Cures Act H.R. 4384, America HEALS ACT Issue: Support establishment of a fund to provide an expanded and sustained investment in biomedical research. H.R. 4879, Research for All Act Issues: Support inclusion of male and female cells, tissues and animals in basic biomedical research. Support update of National Institutes of Health (NIH) guidelines to increase participation of women in clinical trials. Issue: FDA regulation of laboratory-derived tests S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 2645, The Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Submitted comments to: the Food and Drug Administration responding to draft guidance entitled Informed Consent Information Sheet: Guidance for IRBs, Clinical Investigators, and Sponsors. Centers for Medicare and Medicaid Services (CMS) on the CY 2015 Physician Fee Schedule Proposed Rule. Centers for Medicare and Medicaid Services (CMS) on the CY 2015 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs. Centers for Medicare and Medicaid Services (CMS) in support of additional transparency and comment opportunity in the valuation of physician and other healthcare professional services. the Centers for Medicare and Medicaid Services (CMS) to express concern of the delays and complications in the Open Payments Review and Dispute Process.the Departments of Health and Human Services, Labor, and Treasury regarding standards for the use of reference-based pricing structures. Centers for Medicare and Medicaid Services (CMS) on Modifications to the Medicare and Medicaid Electronic Health Record Incentive Programs for 2014 and Revisions to the Certified EHR Technology Definition Proposed Rule. National Quality Forum on its Draft Report: Priority Setting for Performance Measurement: Addressing Performance Measure Gaps for the Health Workforce.

Client expense: $1,250,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Mental Health First Aid Act of 2013 (S. 153/H.R. 274), all provisions related to authorizing a demonstration program to train college faculty and staff in Mental Health First Aid, a community education program that helps people identify, understand, and respond to signs of mental illnesses and addictions and deal with psychiatric crises Behavioral Health Information Technology Act (S. 1517/S. 1685/H.R. 2957), all provisions related to expanding federal incentive payments for the adoption and meaningful use of electronic health records to behavioral health providers and facilities Helping Families in Mental Health Crisis Act of 2013 (H.R. 3717), all provisions related to authorizing healthcare providers to bill Medicaid for mental health and primary care services provided to the same patient on the same day, the reauthorization of the Garrett Lee Smith Memorial Act, the reauthorization of MIOTCRA, enactment of a demonstration program based on the Excellence in Mental Health Act, and strengthening the six protected classes language in Medicare Part D. Strengthening Mental Health in Our Communities Act of 2014 (H.R. 4574), all provisions related to the inclusion of the Mental Health First Aid Act, the reauthorization of important Justice Department initiatives as well as critical SAMHSA programs including the National Suicide Prevention Hotline [1-800-273-TALK], the Garrett Lee Smith Memorial Act suicide prevention programs and the Primary Care Behavioral Health Integration Grants. Caring for Americas Heroes Act (S.2276/H.R. 4656), all provisions related to eliminating the limit on the number of days each year impatient mental health services may be provided to military dependents under the Department of Defense TRICARE program. Caring for Military Children with Developmental Disabilities Act of 2014 (H.R. 4630/S. 2333), all provisions related to including in the treatment of military dependents' developmental disabilities under the Department of Defense TRICARE program behavioral health treatment, including applied behavior analysis, that is prescribed by a physician or psychologist. Craig Thomas Rural Hospital and Provider Equity Act of 2014 (S. 2359), all provisions related to ensuring that residents of rural and frontier communities should have access to affordable, quality health care. Restoring Veterans Trust Act of 2014 (S. 2413), all provisions related to including a new project, the Community Mental Health Partnership Pilot Program, which would connect medical centers of the Department of Veterans Affairs with surrounding community mental health and substance use treatment providers to increase access to services, improve health outcomes, and ensure veterans receive behavioral healthcare that meets the minimum clinical mental health guidelines endorsed by the Veterans Health Administration. H. Res. 572, all provisions related to expressing support for designation of the first full week of May as "National Mental Health No Stigma Week". Opioid Overdose Reduction Act of 2014 (S. 2092/H.R. 4288), all provisions related to exempting from liability for harm caused by the emergency administration of an opioid overdose drug. Opioid Abuse Prevention and Treatment Act (H.R.5587) all provisions related to new grants deterring prescription drug abuse and assisting individuals who are receiving addiction treatment. Overdose Prevention Act (S. 2755) all provisions related to the funding of overdose prevention programming and research efforts to reduce opioid overdose deaths, creation of a task force to recommend a national public health campaign and funding of research and testing of new treatment and prevention methods. Breaking Addictions Act (H.R. 5136), all provisions related to establishing a five-year demonstration project for 8-10 states in which federal reimbursement would be permitted for Medicaid services provided in certain residential settings known as Institutes for Mental Disease. Health Equity and Accountability Act (H.R. 5294) all provisions related to the addition of mental and behavioral health social workers to existing loan repayment programs to bolster the behavioral health workforce. Comprehensive Addiction and Recovery Act (S. 2839) all provision related to a series of resources and incentives to help states and local governments expand drug treatment, prevention and recovery efforts.

Client expense: $96,323 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Emergency Contraception (general); Health Care Reform Implementation. Drug Dependence (general); HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding (general); Medical Liability Reform (general); Health IT (general); Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); Imaging (general); Graduate Medical Education (general); Quality Improvement Measurement (general); Contraception (general); Preeclampsia (general); CMS Provider Penalties (general); National Health Service Corps (general); Abortion (general); Indian Health (general) CMS Health IT incentive program, meaningful use Stage 3; Immigrant Health Care Access; S. 237, Advancing FASD Research, Prevention, and Services Act; S. 333/H.R. 728, Access to Birth Control Act; H.R. 1331, Electronic Health Records Improvements Act; H.R. 1201, Training Tomorrow's Doctors Today Act; H.R. 896/S. 425, Quality Care for Moms and Babies Act; H.R. 1281/S. 1417, Newborn Screening Saves Lives Reauthorization Act; H.R. 36/S. 961, Health Care Safety Net Enhancement Act; H.R. 1975/S. 942, Pregnant Workers Fairness Act; Implementation of H.R. 3204, the Drug Quality and Security Act; H.R. 1915/S. 907 GEDI Act; H.R. 5364 CHIP Extension and Improvement ACT; S. 1009, Chemical Safety Improvement Act; H.R. 2286, Maximizing Optimal Maternity Services for the 21st Century Act; H.R. 4106, Saving Lives, Saving Costs Act; Pregnancy Discrimination (general); S. 1124, BPA in Food Packaging Right to Know Act; H.R. 4240, HEAL Immigrant Women and Families Act; H.R. 4216, Maternal Health Accountability Act; S. 1978, Increasing Primary Care Access Act; H.R. 4435/S. 2410 Carl Levin National Defense Authorization Act for Fiscal Year 2015; H.R. 4385, To Amend the Public Health Service Act to provide for the Designation of maternity care health professional shortage areas; H.R. 4492/S. 1994 TRICARE Moms Improvement Act of 2014; H.R. 4750/S. 1769, Standard of Care Protection Act of 2014; H.R. 2996/S. 2461, CHIP Extension Act of 2014; H.R. 4888 CRIB Act; S. 2722 Protecting our Infants Act; H.R.5524/S. 2687 Access to contraception for Women Service Members and Dependents Act; 21st Century Cures; H.R. 5294 Health Equity and Accountability Act.

Client expense: $352,304 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Treasury, Dept of, White House Office

Suggest improvements to H.R. 4701, the Vector-Borne Disease Research Accountability and Transparency Act Support for H.R. 5294, the Health Equity and Accountability Act of 2014 Support S. 2578, the Protect Women's Health from Corporate Interference Act Comments to CMS regarding Medicare payment methodology for federally-qualified health centers

Client expense: $37,162 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Highway Administration (FHA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), White House Office

Mental Health in Schools Act (S. 195/H.R. 628) Keeping All Students Safe Act (H.R. 1893, S. 2036) Student Support Act (H.R. 320) Garrett Lee Smith Memorial Act Reauthorization of 2013 (S.116/H.R. 2734) The Second Chance Reauthorization Act of 2013 (S. 1690/H.R. 346) Health Equity and Accountability Act of 2014 (H.R. 5294) Mental Health on Campus Act (H.R. 1100) Childrens Trauma Recovery Act (S. 380) Strengthening Mental Health in our Communities Act (H.R 4574) Helping Families in Mental Health Crisis Act (H.R. 3717)

Client expense: $6,333 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Mental Health in Schools Act (S. 195/H.R. 628) Excellence in Mental Health Act (S. 264/ H.R. 1263) Mental Health First Aid Act (S. 153/H.R. 274) Garrett Lee Smith Memorial Act Reauthorization of 2013 (S.116/H.R. 2734) Pediatric Subspecialty and Mental Health Workforce Reauthorization Act (H.R. 1827) Student Support Act (H.R. 320) Childrens Trauma Recovery Act (S. 380) Mental Health Awareness and Improvement Act (S. 689) Mental Health on Campus Act (H.R. 1100) Behavioral Health IT Act (S.1685/H.R. 2957) and Behavioral Health IT Coordination Act (S.1517) FY 2014 Appropriations Justice and Mental Health Collaboration Act of 2013 (MIOTCRA; S. 162/H.R. 401) Helping Families in Mental Health Crisis Act (H.R. 3717) Strengthening Mental Health in our Communities Act (H.R 4574) Medical Evaluation Parity for Servicemembers (MEP) Act (H.R 4305) Promoting Health Minds for Safer Communities Act of 2014 (H.R 4783) Mental Health Awareness and Improvement Act (S. 689) Keeping All Students Safe Act (H.R. 1893, S. 2036) Caring for Americas Heros Act (H.R. 4656/S. 2276 ) The Second Chance Reauthorization Act of 2013 (S. 1690/H.R. 346) Health Equity and Accountability Act of 2014 (H.R. 5294)

Client expense: $6,333 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 116/H.R. 2734 Garrett Lee Smith Memorial Act Reauthorization of 2013 S. 2373 Funding for Research by CDC on Firearms Safety or Gun Violence Prevention H.R. 5294 Health Equity and Accountability Act of 2014 (HIV/AIDS & Mental Health Provisions) Health Disparities Mental and Behavioral Health of Military Personnel, Veterans, and Families H.R. 3717 Helping Families in Mental Health Crisis Act of 2013 H.R. 4574 Strengthening Mental Health in Our Communities Act of 2014 H.R. 4783/S. 2872 Promoting Health Minds for Safer Communities Act of 2014 H.R. 4784 End of Purchase of Firearms by Dangerous Individuals Act of 2014

Client expense: $154,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

FY 15 DOD Appropriations bill. HR 5294

Client expense: Not reported · Firm income: $22,500

Government targets: Defense, Dept of (DOD)

Oppose sequestration cuts which will disproportionately affect family planning services for low income women. Oppose budget cuts that threaten services to populations with unequal access to high quality health care. Support full implemantation of the 2010 Affordable Care Act; oppose efforts to repeal it. Oppose Cruz amendment to S Con Res 8 Support the inclusion of the Healthy Food Financing Initiative (HFFI) amendment in H. R. 1947 / S. 954Support $600 million from oil and gas revenues be invested in the Land and Water Conservation Fund and that the program be fully funded by 2015. Support continued funding for federal programs that are aimed at addressing racial and ethnic health disparities, including the Racial and Ethnic Approaches to Community Health (REACH) Program ($8.59 million increase of $63.49 million for the REACH program); the Office of Minority Health (OMH) at the U.S. Department of Health and Human Services ($55.8 million in FY 2014); the Area Health Education Centers (AHEC) program ($42.5 million in FY 2014); and the Health Careers Opportunity Program (HCOP). Also support $42.5 million for the HSS Office of Civil Rights in FY 2014; $283.3 million for the National Institute on Minority Health and Health Disparities in FY 2014; $520 million for Title VII and Title VIII of the Public Health Service Act n FY 2014; $327 million for Title X of the Public Health Service Act in FY 2014; $1.58 billion level discretionary funding in addition to maintaining all funds available through the mandatory Health Center Fund for Community Health Centers in FY 2014; $2.668 billion for the Ryan White Program in FY 2014; and a sufficient in amount to meet data collection objectives across HHS agencies, divisions, and programs in FY 2014. Support $7.9 billion in FY 2014 from the Department of Health and Human Services for Head Start activities. Oppose H.R. 2667. Oppose H.R. 2668. Support full implememntation of the 2010 Affordable Care Act. Oppose H.R. 45. Oppose Schweikert amendment to H.R. 1947 striking funds for the Healthy Food Financing Inititative. Ensure the full implememtation of the Affordable Care Act in Mississippi. Oppose H.R. 2775. Oppose H.R. 2009. Oppose H.R. 367. Stated that in response to questions regarding Section 1557 of the Afordable Care Act that the burdens of costly health care are not distributed evenly. Rather, they fall disproportionately on communities of color, which are more likely to experience higher rates of unemployment, to have jobs that do not have health insurance, and to have lower incomes that put higher insurance premiums out of their financial reach. Support Health Care Equity, especially as it applies to racial and ethnic minorities. Support the recommendation by the US Preventative Services Task Force on Lung Cancer Screening, giving such screening a favorable grade of B. Urged the Department of Health and Human Service's Office of Civil Rights (OCR) to administer section 1557 of the Affordable Care Act, through robust implementation and enforcement mechanisms, in the final regulations that OCR promulgates. Support data about how new drugs and devices work in women, minorities, and older Americans be publicly available to patients, clinicians, and researchers on a consistent and reliable basis.Support for including the following programs in any year-end health extenders package: the Qualified Individual (QI) program, the Transitional Medical Assistance (TMA) program, and Express Lane Eligibility (ELE) as well as the state incentive payment provisions and funding for quality improvement in the Childrens Health Insurance Reauthorization Act (CHIPRA). Support Protecting Seniors from Medication Labeling Mistakes. Oppose HR 4118. Support a release of the enrollment in the Affordable Care Act disaggregated by age, race, ethnicity, and primary language. Support improving the Tax Code to advance cost-effective policies that can bolster healthy lifestyles in key populations, and hold promise for halting or reversing the nations costly and unsustainable obesity epidemic. Support bringing the Affordable Care Act into compliance with the National Voter Registration Act of 1993 (NVRA). Support coverage of lung cancer screening as a Medicare benefit consistent with the final favorable recommendation of the US Preventive Services Task Force (USPSTF) issued December 31, 2013. Support lifting the ban on federal funding for syringe services programs (SSPs). Support President Obama's Boys and Young Men of Color Initiave, amd urge the initiative to focus on the following principals: Promoting Healthy Children, Families and Communities; Ensuring Educational Opportunity; Decriminalizing Young People of Color; Creating ; Economic Opportunity; and Promoting and Protecting Civic and Community Engagement. Support H.R. 4765. Support coverage of lung cancer screening as a Medicare benefit consistent with the final favorable recommendation of the US Preventive Services Task Force (USPSTF) , which gave the process a "B" grade. Support requested funding for the Ryan White HIV / AIDS Program, which offers health services for people living with HIV / AIDS, be set at $2.32 billion. Support HR 4810. Support the Nadler (NY) Housing for Persons with AIDS amendment to HR 4745. Oppose H. Res. 676. Support the Capps (CA) motion to recommit H.R. 935. Oppose H.R. 935. Oppose HR 3522. Support the request to the FDA to extend the comment period in Docket No.FDA-2013-N-0500, RIN 0910-AG94, in order to hear from healthcare and other stakeholders including providers and leaders who serve female, racial and ethnic minority populations, constituencies and consumers and who could offer expertise, experience, and perspective. Support H.R. 5294.Support full funding in FY15 for the Racial and Ethnic Approaches to Community Health (REACH) Program, the Office of Minority Health (OMH) at the U.S. Department of Health and Human Services, the Area Health Education Centers (AHEC) program, and the Health Careers Opportunity Program (HCOP). Support S. 2841 / H.R. 5507. Support a four-year extension of the Childrens Health Insurance Program (CHIP). Support HR 4765. Oppose funding cuts to programs which provide care and treatment, prevention, housing and support services for people with HIV/AIDS.

Client expense: $68,750 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Credit Union Administration (NCUA), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Commission on Civil Rights, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office